心肌应变评估瓣膜病患者瓣膜置换术后临床短期疗效的研究(1)
[摘要] 目的 探讨心肌应变在瓣膜置换术后短期疗效中的应用价值。 方法 便利选取42例瓣膜病患者，就诊时间为2017年5月—2018年5月期间，另选取30名健康志愿者作为对照组，患者均于瓣膜置换术前、术后1周、术后1个月行超声心动图检查，获取左室节段应变参数，并进行对比分析，并观察术前异常节段应变参数在术后1周、术后1个月的变化情况。结果 与对照组比较，瓣膜病组患者术前、术后1周、术后1个月，GLSepi、GLSendo、GCSendo 及GCSepi均减低(P<0.05)，GLSepi不同时间段分别为(-14.5±1.5)%、(-8.7±1.2)%、(-11.4±2.5)%;GLSendo分别为(-19.9±1.5)%、(-12.1±3.5)%、(-17.6±3.2)%;GCSendo分别为(-25.8±3.5)%、(-17.3±3.5)%、(-19.1±4.3)%;GCSepi分別为(-12.2±1.5)%、(-7.5±1.5)%、(-9.3±1.8)%;与术前比较，瓣膜病组患者术后1周时上述指标均减低(P<0.05)，术后1个月时GCSendo 和GCSepi减低(P<0.05);与术后1周比较，术后1个月时GLSendo 和GLSepi明显增高，而GCSendo 和GCSepi无明显变化;相比于术前，瓣膜组患者术后1周时TRS(18.1±4.5)%、TCS(-7.4±1.5)%均减低(均P<0.05)，TLS无明显变化，术后1个月时TRS(10.4±3.5)%明显减低，TLS(-13.9±2.5)%明显增高(P<0.05)，TCS无明显变化;与术后1周比较。与术前比较，术后1周时TCSendo(-12.1±2.2)%明显减低(P<0.05)，而TCSepi、TLSepi、TLSendo无明显变化，术后1个月时TLSendo(-15.9±2.2)%增高极其明显(P<0.01)，TLSepi(-12.1±2.2)%、TCSendo(-14.5±2.5)%均增高(均P<0.05);术后1个月TLSendo(-15.9±2.2)%、TLSepi(-12.1±2.2)%与术后1周比较明显增高(P<0.05)，TCSepi、TCSendo与术后1周比较变化不明显(P>0.05)。结论 瓣膜病患者术后检测2D-STI心肌应变参数，能对术后临床短期疗效进行客观评价。
[关键词] 瓣膜置换术;瓣膜病;心肌应变
[中图分类号] R445.1;R654.2 [文献标识码] A [文章编号] 1674-0742(2018)12(c)-0042-03
[Abstract] Objective To study the application value of myocardial strain in evaluating the patients with valvular heart disease after the replacement. Methods 42 cases of patients with valvular heart disease from May 2017 to May 2018 were selected as the observation group， while 30 cases of healthy volunteers in our hospital were convenient selected as the control group， and the patients were for echocardiography before the valve replacement and in 1w and 1 month after surgery， and the left ventricular segmental strain parameters were obtained， and the changes of abnormal segment strain parameters in 1 week and 1 month after surgery were observed. Results The GLSepi， GLSendo， GCSendo ， GCSepi before surgery， in 1 week and 1 month after surgery in the valvular heart disease group decreased compared with those in the control group(P<0.05)， and the GLSepi scores in different time stages were respectively (-14.5±1.5)%， (-8.7±1.2)%， (-11.4±2.5)%， and the GLSendo were respectively (-19.9±1.5)%， (-12.1±3.5)%， (-17.6±3.2)%， and the GCSendo were respectively (-25.8±3.5)%， (-17.3±3.5)%， (-19.1±4.3)%， and the GCSepi scores were respectively (-12.2±1.5)%， (-7.5±1.5)%， (-9.3±1.8)%， and the above indicators in 1 w after surgery in the valvular heart disease group decreased compared with that before surgery(P<0.05)， and the GCSendo and GCSepi decreased in 1 month after surgery(P<0.05)， and the GLSendo and GLSepi obviously increased in 1 month after surgery obviously increased compared with that in 1 w after surgery， but there were no obvious changes in the GCSendo and GCSepi， and the TRS(18.1±4.5)%， TCS(-7.4±1.5)% decreased in 1 w after surgery in the valve group(P<0.05)， and TLS had no obvious changes， and TRS obviously decreased in 1 month after surgery (10.4±3.5)%， and TLS (-13.9±2.5) % obviously increased(P<0.05)， and TCS had no obvious change， and the TCSendo(-12.1±2.2) % obviously decreased in 1 week after surgery compared with that before surgery(P<0.05)， but there were no obvious changes in the TCSepi， TLSepi， TLSendo， and the TLSendo(-15.9±2.2) % obviously increased in 1 month after surgery(P<0.01)， and TLSepi(-12.1±2.2) %， TCSendo(-14.5±2.5) % increased(P<0.05)， and the TLSendo(-15.9±2.2)%， TLSepi(-12.1±2.2) % obviously increased in 1 month obviously increased compared with those in 1 week after surgery(P<0.05)， and the changes of TCSepi， TCSendo were not obvious compared with those in 1 week after surgery(P>0.05). Conclusion The postoperative test of 2D-STI myocardial strain parameters in patients with valvular heart disease can conduct the objective evaluation of postoperative clinical short-term curative effect., 百拇医药(廖剑)
[关键词] 瓣膜置换术;瓣膜病;心肌应变
[中图分类号] R445.1;R654.2 [文献标识码] A [文章编号] 1674-0742(2018)12(c)-0042-03
[Abstract] Objective To study the application value of myocardial strain in evaluating the patients with valvular heart disease after the replacement. Methods 42 cases of patients with valvular heart disease from May 2017 to May 2018 were selected as the observation group， while 30 cases of healthy volunteers in our hospital were convenient selected as the control group， and the patients were for echocardiography before the valve replacement and in 1w and 1 month after surgery， and the left ventricular segmental strain parameters were obtained， and the changes of abnormal segment strain parameters in 1 week and 1 month after surgery were observed. Results The GLSepi， GLSendo， GCSendo ， GCSepi before surgery， in 1 week and 1 month after surgery in the valvular heart disease group decreased compared with those in the control group(P<0.05)， and the GLSepi scores in different time stages were respectively (-14.5±1.5)%， (-8.7±1.2)%， (-11.4±2.5)%， and the GLSendo were respectively (-19.9±1.5)%， (-12.1±3.5)%， (-17.6±3.2)%， and the GCSendo were respectively (-25.8±3.5)%， (-17.3±3.5)%， (-19.1±4.3)%， and the GCSepi scores were respectively (-12.2±1.5)%， (-7.5±1.5)%， (-9.3±1.8)%， and the above indicators in 1 w after surgery in the valvular heart disease group decreased compared with that before surgery(P<0.05)， and the GCSendo and GCSepi decreased in 1 month after surgery(P<0.05)， and the GLSendo and GLSepi obviously increased in 1 month after surgery obviously increased compared with that in 1 w after surgery， but there were no obvious changes in the GCSendo and GCSepi， and the TRS(18.1±4.5)%， TCS(-7.4±1.5)% decreased in 1 w after surgery in the valve group(P<0.05)， and TLS had no obvious changes， and TRS obviously decreased in 1 month after surgery (10.4±3.5)%， and TLS (-13.9±2.5) % obviously increased(P<0.05)， and TCS had no obvious change， and the TCSendo(-12.1±2.2) % obviously decreased in 1 week after surgery compared with that before surgery(P<0.05)， but there were no obvious changes in the TCSepi， TLSepi， TLSendo， and the TLSendo(-15.9±2.2) % obviously increased in 1 month after surgery(P<0.01)， and TLSepi(-12.1±2.2) %， TCSendo(-14.5±2.5) % increased(P<0.05)， and the TLSendo(-15.9±2.2)%， TLSepi(-12.1±2.2) % obviously increased in 1 month obviously increased compared with those in 1 week after surgery(P<0.05)， and the changes of TCSepi， TCSendo were not obvious compared with those in 1 week after surgery(P>0.05). Conclusion The postoperative test of 2D-STI myocardial strain parameters in patients with valvular heart disease can conduct the objective evaluation of postoperative clinical short-term curative effect., 百拇医药(廖剑)